Provider Demographics
NPI:1053306290
Name:DILLON, CAROL ANNE (DO)
Entity type:Individual
Prefix:
First Name:CAROL ANNE
Middle Name:
Last Name:DILLON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 NEWTOWN RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-5206
Mailing Address - Country:US
Mailing Address - Phone:215-674-3337
Mailing Address - Fax:215-674-4247
Practice Address - Street 1:205 NEWTOWN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-5206
Practice Address - Country:US
Practice Address - Phone:215-674-3337
Practice Address - Fax:215-674-4247
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS011854208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
7579493OtherAETNA PPO
2238420000OtherKHPE
1866307OtherAETNA HMO
H99560Medicare UPIN